Vocational Rehabilitation Services Manual D-200: Purchasing Goods and Services

The state and federal laws governing the purchase of goods and services for VR customers include the following:

• Education Department General Administrative Regulations, 34 Code of Federal Regulations (CFR) Parts 76, 77, 79, 81, and 82
• 34 CFR Part 361
• 2 CFR Part 190, as adopted in 2 CFR Part 3485
• 2 CFR part 200, as adopted in 2 CFR Part 3474
• 34 Texas Administrative Code, Part I, Chapter 20, Statewide Procurement and Support Services
• Texas Government Code, Chapter 2155

VR does not discriminate on the basis of race, color, sex, national origin, age, disability, or veteran status when purchasing goods and services for customers.

D-201-1: Policy, Procedure, and Guidance Documents

VR counselors, designated technicians, and other VR staff members who purchase goods and services for customers also must follow the policies, procedures, and guidance published in the following TWC manuals:

• Vocational Rehabilitation Services Manual
• VR Standards for Providers Manual
• Criss Cole Rehabilitation Center Policy Manual (Word)
• VR Guidance and Information Memoranda
• Independent Living Services for Older Individuals Who Are Blind Policies and Procedures Manual (Word)
• Medical Services Required Practices Handbook (PDF)
• MOSAIC (Monitoring Oversight and Internal Controls) Process Guide (Word)
• ReHabWorks (RHW) User's Guide
• Texas Review, Oversight, and Coaching System (TxROCS) User's Guide (Word)

All goods and services purchased with VR funds must be appropriate and necessary to support a competitive integrated employment outcome.

For additional information about documentation requirements for purchasing, refer to D-202-1: Documentation Requirements.

When authorizing the purchase of a good or service, the VR counselor considers:

• the cost, accessibility, type, and duration of the services;
• the customer's informed choice;
• the customer's satisfaction with the proposed services;
• the provider's compliance with the Americans with Disabilities Act;
• the qualifications of the service provider;
• the setting in which the services are provided; and
• the provider's history of success with other customers.

Additionally, the following must also be considered for each purchase:

• Best value
• Use of comparable benefits
• Required customer participation in cost of services (also referred to as BLR)
• Separation of duties
• Ethics and purchasing

D-203-1: Informed Customer Choice

The customer (and, as appropriate, his or her representatives) must be involved in decision making related to all aspects of the customer's VR services, including selecting the goods, services, and providers during the purchasing process.

The VR counselor must document in a case note the customer's involvement in the selection of goods, services, and providers.

For more information about informed choice and the VR process, refer to B-102: Informed Choice.

D-203-2: Best Value Purchasing

Because VR uses tax revenue to pay for services, VR must purchase the least expensive services that meet the customer's vocational needs.

To accomplish this, VR staff members apply the best-value purchasing approach. The approach ensures that, when authorizing a purchase, staff members consider not only the initial cost but also the factors that influence the total cost and value to both the customer and TWC.

These factors include, but are not limited to:

• installation costs;
• warranties;
• life-cycle costs;
• quality and reliability;
• delivery costs and terms;
• the timeliness of the delivery;
• the cost of training associated with a purchase; and
• the indicators of the provider's probable performance (for example, the provider's past performance, financial resources, ability to perform, experience, responsibility, reputation, and ability to provide reliable maintenance and support).

D-203-3: Comparable Services and Benefits

Comparable services and benefits, including accommodations and auxiliary aids and services, are resources that are provided or paid for, in whole or in part, by other Federal, State, or local public agencies, by health insurance, or by employee benefits. These resources must be available to VR customer at the time needed and they must be commensurate to the services that the customer would otherwise receive from the TWC-VR. (Based on 34 CFR §361.5(c)(8).)

Comparable services and benefits do not include:

• scholarships or other awards of merit;
• student loans;
• personal loans; or
• customer contributions to the cost of services.

Requirement to Use Comparable Services and Benefits

When a customer is determined eligible for VR services, 34 CFR §361.53 requires that prior providing any VR service, TWC-VR must determine whether comparable services and benefits exist under any other program and whether those services and benefits are available to the customer. When comparable services benefits are available, these resources must be used for planned services before using VR funds.

Exceptions for Use of Comparable Services and Benefits

Comparable services and benefits must be utilized unless doing so would significantly interrupt or delay:

• the progress of the customer toward achieving the employment outcome identified in the IPE;
• an immediate job placement; or
• the provision of VR services to any individual who is determined to be at extreme medical risk, based on medical evidence provided by an appropriate qualified medical professional.

The VR Manager must approve any exceptions to the use of available comparable benefits for the above reasons. Otherwise, no exceptions are allowed to this policy.

While all available resources should be utilized to ensure compliance with D-203-2: Best Value Purchasing, the requirement to use comparable services and benefits does not apply to the following goods and services:

• Assessments for determining eligibility and VR needs;
• Counseling and guidance;
• Referral and other services to secure needed services from other agencies;
• Job-related services, including job search and placement assistance, job retention services, follow-up services, and follow-along services; and
• Rehabilitation technology, including telecommunications, sensory, and other technological aids and devices.

Federal Financial Aid

If the customer needs postsecondary training to reach the IPE goal, the customer must be informed that he or she is required to apply for and use, if granted, support from the Federal Financial Student Aid Program that does not include a payback requirement. When applicable, include this requirement on the IPE. Refer to VRSM C-405: Financial Aid and Comparable Benefits for additional information.

Services and Benefits for Veterans

The US Department of Veterans Affairs has a range of benefits available to veterans of the military, naval, and air services, and to certain members of their families. Among the benefits available to service-disabled veterans and their families are several types of financial assistance, including monthly cash payments, health care, housing benefits, and educational benefits.

In addition, additional resources for veterans are:

• Centers for Independent Living;
• Community Services for the Blind;
• TWC's Texas Veterans Leadership Program;
• Texas Veterans Commission; and
• the Hazelwood Act.

For additional information, refer to A-304: Veterans with Disabilities.

Insurance as a Comparable Benefit

VR is the payor of last resort. Comparable benefits and the customer's required participation in the cost of services must be applied before VR funds are spent.

After the customer's primary and/or secondary benefit coverage has been applied and the customer's ability to pay has been determined, if VR is paying a portion of the total owed to the provider, VR may pay an amount equal to the customer's copayment, coinsurance, or deductible due.

VR payment must not exceed:

• the amount allowed by the customer's insurance;
• the allowable VR rate; or
• the VR contract rate, whichever is less.

Documenting Use of Comparable Services and Benefits

The exploration of and use and non-use of comparable services and benefits must be thoroughly documented in the customer's case file. This includes documentation in ReHabWorks (RHW):

• Case notes
• Service records
• IPE or IPE amendments
• Closure Services page.

Copies of documents related to approval or denial of comparable benefits must be filed in the customer's paper case file.

Substantial or supportive goods and services that are necessary for the customer to reach the identified employment goal and are arranged by a comparable benefit must be documented by an arranged service record in RHW. For additional information on creating service records, refer to RUG E-200: Case Service Records. For additional information on planned services, refer to VRSM B-504-5: Planned Services.

Documenting Comparable Benefits in ReHabWorks

The following comparable benefits selections can be selected to document the use of comparable benefits when service records, IPEs, and Closure Services pages are developed in ReHabWorks:

• Centers for Independent Living
• Child Protective Services
• Educational Institutions (elementary and secondary)
• Educational Institutions (postsecondary)
• Educational Service Center
• Employers
• Employment Networks (not otherwise specified)
• Federal Student Aid (such as Pell grants, SEOP (Supplemental Educational Opportunity Grant), work study, etc.)
• Intellectual and Developmental Disabilities Agencies
• Lion's Club
• Medicaid Programs
• Medicaid Waiver
• Medical Health Provider (public or private)
• Medicare
• Mental Health Provider (public or private)
• One-Stop Employment and Training Centers
• Other Sources
• Other State Agencies
• Other VR State Agencies
• Public Housing Authority
• Scholarship
• Social Security Administration (Disability Determination Services or District office)
• State Department of Correction and Juvenile Justice
• State Employment Service Agency
• Tuition Waiver (non-blind, non-deaf)
• Tuition Waiver Blind
• Tuition Waiver Deaf
• Veteran's Administration
• Waiver Programs—MDCP In-Home, CLASS & Family Support Class
• Welfare Agency (state or local government)
• Worker's Compensation

D-203-4: Customer Participation in the Cost of Services

A customer's eligibility for VR services does not depend on the customer's income or liquid assets; however, if the customer's net income or liquid assets exceed the basic living requirements (BLR), the customer must participate in the cost of services.

For a list of services that explains when BLR is or is not applied, refer to E-400: Applying Basic Living Requirements (BLR) to VR Services.

The monthly net income and liquid assets levels that are used to calculate the customer's required contribution to the cost of services are available on the VR Basic Living Requirements (BLR) intranet page.

Exception

A customer whose net income or liquid assets exceed the BLR is not required to help pay for services, if:

• the customer is eligible for Social Security disability benefits—that is, Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI); or
• the VR Supervisor grants an exception because the customer's participation would prevent the customer from receiving a necessary service.

The VR counselor must inform the customer that failure to provide complete and accurate financial information:

• violates federal and Texas law; and
• may result in a denial or delay of services that are not exempt from customer contribution requirements.

Determining the Customer's Requirement and Ability to Participate

To determine whether a customer must participate in the cost of services and his or her financial ability to do so, the VR counselor uses the following four-step procedure.

1. Determine whether the customer is required to participate in the cost of services

   When determining whether the customer is required to participate in the cost of services, VR staff:

   • considers the monthly net income and liquid assets of the customer;
   • considers the monthly net income and liquid assets of the customer's spouse (if applicable); and
   • considers the monthly net income and liquid assets of the parent or legal guardian if the customer is claimed as a dependent for purposes of federal income taxes; and
   • compares the total monthly net income and liquid assets BLR levels.

   NOTE: When completing the Monthly Financial Information screen in RHW, the customer's net income must be entered in the Economic Resources section to get an accurate BLR calculation. 

2. Obtain documented proof of the all income and expenses.

   When an individual applies for services, the VR counselor requests documented proof of all:

   • income (excluding any payment in-kind, such as food stamps or housing subsidies);
   • liquid assets (cash plus assets that are easily converted to cash);
   • expenses; and/or
   • any allowable additions to the BLR.

   A customer who is eligible for Social Security disability benefits (SSI or SSDI) provides only proof of Social Security eligibility. The law exempts recipients of Social Security disability benefits from the requirement to participate in the cost of VR services regardless of income, so no additional proof of income or expenses is required.

3. Calculate the customer's contribution.

   When the customer's liquid assets exceed the BLR level after including any allowable BLR additions, the customer must contribute an amount equal to the excess toward the cost of goods and services.

   For each month in which VR pays for goods and/or services, the customer must contribute the difference between the customer's monthly net income and the BLR level after including any allowable BLR additions.

   The customer's contribution must not exceed the cost of the good and/or service.

   A customer whose net income or liquid assets is under the BLR is not required to contribute to their VR services. However, maximum amounts and rates published in the VRSM still apply.

   For example:

   The cost for a customer to attend a 4-year college or university may cost $7,000 for 15 credit hours. The VR tuition and fees maximum limit for 15 hours is $5,835. If the customer is under BLR, they will not be required to contribute toward the $5,835. However, the customer will be required to contribute to the remaining amount over the maximum limit which in this example is $1,165.

   The total amount that the customer is required to pay must be received prior to any service authorization being issued. For more information, refer to "Payments" in this section.

   Note: Exceptions may be made to this policy as stated above under "Exception".

4. Review, periodically, the customer's proof of income and expenses.

   At least annually, the VR counselor:

   • reviews the customer's income, liquid assets, and expenses; and
   • documents the review results in a RHW case note.

If the customer's income, liquid assets, or expenses change significantly during the life of the case, the VR staff

• reassesses whether the customer must participate in the cost of services;
• documents proof of the changes (and, if documentation is not available, notes the reason in a case note);
• updates the financial information in RHW; and
• documents the reason for the change in the comment section of the financial information page at the time of the update (this will create a case note in RHW when the changes to the page are saved).

If the customer's IPE is developed before proof of income and expenses is received, the VR counselor does not include services that require the customer's participation in the cost (see list of service exempt from customer participate below).

When proof of income and expenses are received, the VR counselor amends the IPE as needed.

Types of Income, Liquid Assets, and Required Proof

The table below lists the types of income and corresponding proof required of the customer, spouse, and parent (if the customer is claimed as a dependent).

Income	Proof Required
Net wages and net income from other enterprises	Requires: a check stub; a bank statement; or an earnings statement.
Social Security disability benefits (SSI or SSDI) received by the customer for their disability	No proof is required for the actual income amount of the customer's SSI or SSDI checks; however, proof of eligibility for SSI or SSDI benefits must be in the customer's case file.
All other Social Security benefits (for example, survivor or retirement benefits received by the customer or the customer's spouse or parents, Social Security disability received by the customer's spouse or parents, and so on)	Requires: an award letter; a check stub; an income tax return; or a bank statement.
The following income received by the customer: Public support payments VA income benefits Unemployment compensation income Workers' Compensation income Private disability insurance Annuities	Requires: an award letter; a check stub; an income tax return; or a bank statement.
Child support payments received by the customer	Requires: an award letter; a check stub; an income tax return; a court order; or a bank statement.

 

Liquid Assets	Proof Required
Cash and assets from savings or other accounts.	Account statements

Refusal to Provide Financial Information

Customers have the right not to disclose their financial information. However, when a customer declines to provide the information, VR assumes that the customer has resources that exceed the BLR level, after including any allowable BLR additions. In such a case, the customer must fully participate in the cost of planned services, except in the case of the services listed in "Services Exempt from the Customer's Cost Participation" below.

Calculating Customer Participation

The customer's required contribution to the cost of services is referred to as the Basic Living Requirements (BLR).

RHW is designed to automatically calculate a customer's participation based on:

• 300 percent of the United States Health and Human Services Poverty Guidelines; and
• the customer's income, family status, and economic need, as entered in RHW.

See the U.S. Department of Health and Human Services Poverty Guidelines for the current fiscal year and see VR's BLR tables; these tables are available to the public upon request.

RHW determines the amount that a customer must contribute to the cost of services, based on the customer's net monthly income and family size as related to the poverty guidelines for the current fiscal year.

The amount is calculated as monthly but is applied only in the months that a service or good is provided that requires participation in cost of services.

Allowable Additions to BLR

The total monthly costs of the allowable additions below are automatically added to the BLR when entered in RHW.

Allowable Additions	Proof Required
Monthly home mortgage or rental payments	Required: statement; canceled check; money order stub; contract; and lease.
Prescribed diet and medicines used by the customer	Required: itemized receipts; or canceled checks.
Debts imposed by court order	Court record
Medical costs and disability-related expenses of the customer Based on 34 CFR §361.54(b)(2)	Required: itemized statements; or canceled checks.

Payments

When feasible, except for MAPS and contract services, a customer who is participating in the cost of goods and/or services pays the service provider directly. When direct payment to the provider is not feasible, the VR counselor arranges for the customer to submit the required amount to TWC-VR by check or money order.

However, if authorizing the purchase of hearing aids, accessories, or hearing aid service charges and the customer exceeds BLR, the customer must submit the required amount to TWC-VR by check or money order.

When paying TWC-VR, the total amount that the customer is required to pay must be received prior to any service authorizations being issued.

When receiving a payment from a customer to meet BLR requirements, the VR counselor or RA:

• documents the receipt of the check or money order in a case note in RHW;
• files copies of the check or money order in the customer's case file; and
• follows the process documented in VRSM D-505-1: Refunds.

In-kind payments

The customer may pay "in kind" for certain services listed on the IPE; for example, paying for transportation to receive services, or paying for uniforms, textbooks, and the like.

Services Exempt from the Customer's Cost Participation

The VR counselor reviews with the customer the customer's agreement to pay for the cost of services.

For a list of services that explains when BLR is or is not applied, refer to E-400: Applying Basic Living Requirements (BLR) to VR Services.

Services exempt from the customer's cost participation include the costs for:

• the assessment for determining the customer's eligibility;
• the assessment for determining the customer's VR needs, including associated maintenance and transportation;
• VR counseling and guidance and referral for other services;
• in-house services provided directly by VR staff;
• job-related services, including job search and placement assistance, job retention services, follow-up services, and follow-along services;
• personal attendant services;
• any auxiliary aid or service (for example, interpreter services) that a customer with a disability requires to participate in the VR program;
• diabetes education services;
• orientation and mobility services;
• Pre-Employment Transition Services (Pre-ETS); and
• other VR services that directly support Pre-ETS, like transportation, maintenance, and personal assistant services (applicable for VR eligible students only).

This policy must be applied uniformly to all customers in similar circumstances.

SSI and/or SSDI Recipients

Customers eligible for SSI or SSDI because of a disability are exempt from the cost participation requirement. Limitations on payments (for example, on payment of tuition and fees) are also not applied; however, VR policy on the use of best value and comparable services and benefits must be followed for all VR customers.

Potentially Eligible Customers

BLR does not apply to services that are provided directly to potentially eligible VR customers; however, policy on the use of best value and comparable services and benefits must be followed for all VR customers.

Students or Youth with Disabilities

The BLR does not apply to:

• the cost of participation in training seminars and GSTs for students or youth with disabilities (see C-1307-1: Student Participation in the Cost of Training Seminars and GSTs); or
• the cost of parents or legal guardians to participate in the training seminars and GSTs for students or youth with disabilities (see C-1307-2: Family Participation in Training Seminars and GSTs).

VR policy on the use of best value and comparable services and benefits must be followed for all VR customers.

D-203-5: Separation of Duties

To minimize conflict of interest, RHW is designed so that the same VR staff member may not authorize payment for an SA that the staff member created or made changes to at any point in the purchasing process.

At least two staff members must complete each purchase—that is, issue, receive, and authorize payment—to ensure that integrity is maintained throughout the purchasing process.

For additional information about processing an SA in RHW, see RUG E-300: Case Service Authorizations, E-304: New Service Authorization.

D-203-6: Ethics of Purchasing

As stewards of VR funds, VR staff members have a personal and professional responsibility to maintain a high level of ethical standard when purchasing goods and services for VR customers. VR staff members are required to follow all purchasing policies and procedures published in the VRSM and the VR-SFP.

Purchasing ethics for state government are also governed by the Texas Ethics Commission, which interprets laws governing the conduct of state officers and employees.

The following state laws apply:

• Texas Government Code, Chapters 305 and 572
• Texas Penal Code, Chapters 36 and 39

State Ethics Policy

In addition to the content below, VR staff members must also comply with the TWC Personnel Manual, 1.9 Ethics/Standards of Conduct (PDF) and TWC's Ethics policy (DOCX).

"State law mandates that no State Officer or employee shall have a direct or indirect interest in, or engage in, any business transaction or professional activity, or incur any obligation that conflicts with the proper discharge of that individual's duties for the state.

Further, a state employee shall not:

1. accept or solicit any gift, favor, or service deemed to be of personal benefit or value that might reasonably tend to influence the performance of official duties or that the employee knows, or should know, is being offered to intentionally influence the employee's official conduct;
2. accept employment or engage in any business or professional activity that the employee might reasonably expect would require the employee to disclose confidential information that is obtained through the employee's official position, including information that is excepted from public disclosure by law or TWC rule under the Texas Public Information Act, or information that has been ordered sealed by a court;
3. accept other employment, including self-employment, or compensation or engage in a business activity that could reasonably be expected to impair the employee's independence of judgment in performing official duties;
4. make personal investments that could reasonably be expected to create a substantial conflict between the employee's private interest and the public interest; or
5. intentionally or knowingly solicit, accept, or agree to accept any benefit for having exercised official powers or performed official duties as a favor."

Ethical Violations

"Agency employees who violate provisions of the ethics policy are subject to disciplinary action, up to and including dismissal from employment. Further, any employee who violates the ethics policy is subject to any applicable civil or criminal penalty if the violation also constitutes a violation of another statute or rule."

Bribery

Texas Penal Code §36.02

"A. The Texas Penal Code states that a state employee commits an offense if that employee knowingly or intentionally offers, gives, or agrees to give to another person any benefit as a consideration for the employee's decision, opinion, recommendation, vote or other exercise of discretion as the employee or any benefit as consideration for a violation of a duty imposed by law on the employee.

B. Under the Texas Penal Code, any TWC employee who exercises any discretion as to TWC contracts is forbidden from accepting any benefit from any person interested in any TWC contract or from any person who is likely to become interested in any TWC contract in which the employee exercises discretion. Such behavior is a criminal offense under the Texas Penal Code."

Gifts, Favors, or Services

Texas Penal Code §36.07 and §36.08

"TWC employee shall not accept or agree to accept, directly or indirectly, any favor, gift, loan, free service, or other item deemed to be of personal benefit or value in any form from any person or organization outside of TWC if it is intended, or would appear, to reward or influence the employee's official actions. This simply means that you should never accept anything if it might make you do your job differently, if you think the person giving it to you has the hope you will do your job differently, or if it might appear to others that you have done your job differently."

Appearance of Impropriety

In addition to following purchasing policies and procedures, VR staff members must also avoid the appearance of impropriety when they are representing TWC-VR.

VR staff members must consult with their VR Supervisor or VR Manager, as needed, when they have questions or concerns about purchasing-related ethics.

D-203-7: Service Category Codes

In ReHabWorks, there is a drop-down list of service descriptions from which an entry is selected when creating a service record. The selected service category code helps determine the applicable receiving and payment requirements enforced by ReHabWorks and may be used by the system to determine whether a transaction can be paid in advance. Proper selection of the service category code supports VR's ability to ensure:

• compliance with federal reporting obligations;
• proper use of VR funds;
• compliance with state comptroller requirements; and
• proper categorization of goods and services for the SSA-VR reimbursement process.

Staff must use the correct service category code for the good or service being authorized, and service category code selection is reviewed as a part of the formal technical and purchasing case review process. For questions about service category code selection process, VR staff can email vr.rhw.providerservices@twc.texas.gov.

Purchasing thresholds are established to ensure that management oversees purchases in accordance with the VR Grant award (2 CFR 200) regarding the use of internal controls and compliance with state procurement requirements. VR counselors must review associated chapters in the VRSM and VR-SFP in addition to reviewing VRSM E-200: Summary Table of Approvals, Consultations, and Notifications prior to including the service on an IPE and authorizing the purchase of any good or service.

Purchasing threshold requirements are in addition to any other published policies and procedures for the purchase of specific goods and services.

Purchases must not be split (separated into multiple purchases) to avoid purchasing threshold requirements in this section and throughout the VRSM. For more information, refer to D-203-6: Ethics of Purchasing.

D-205-1: Approval Requirements by Threshold

All purchases of goods or services must be authorized by the VR counselor and documented clearly in a case note or the customer's IPE and a service authorization must be issued. For more information, refer to E-300: Case Note Requirements, Service Justification and B-500: Individualized Plan for Employment and Post-Employment for more details.

The following approvals must be documented using an approval case note or using the RHW Purchase Approval Workflow if combining with other required approvals for the proposed purchase prior to issuing a service authorization for the purchase of a good or service:

• Greater than $5,000 to $15,000 – VR Manager approval required.
• Greater than $15,000 to $25,000 – Regional director or deputy regional director approval required.
• Greater than $25,000 – Regional director or deputy regional director, and VR Division Director approval required.

Refer to D-205-4: Exceptions to Purchasing Threshold Requirements for a specific list of goods or services that are exempt from these threshold requirements.

For more information, including additional approval, consultation, and notification requirements, refer to E-200: Summary Table of Approvals, Consultations, and Notifications.

D-205-2: Pre-purchase Review

In addition to requirements throughout the VRSM and the VR Standards for Providers (VR-SFP), for all purchases that are over $5,000 per service authorization or per customer in a multicustomer SA, a pre-purchase review must be completed by the administrative supervisor, purchasing specialist, or the final approver (e.g., the VR Manager) prior to the purchase. The purpose of a pre-purchase review is to ensure that all required policies, procedures, and approvals applicable to the specific purchase have been followed and as required, documented prior to issuing the service authorization (SA).

When a pre-purchase review is required for a multicustomer SA, separate pre-purchase reviews must be completed for each applicable customer to ensure the purchase is compliant in each case.

When a RHW Purchase Approval is required, the pre-purchase review is completed after or in combination with the RHW Purchase Approval.

Pre-purchase reviews are documented in ReHabWorks using the "Purchasing Pre-review" case note topic or through the RHW Workflow if combining with other approvals. Refer to E-300: Case Note Requirements, Purchasing Pre-Review for specific documentation requirements.

If an approver has reviewed and documented an element of the pre-purchase review requirements as part of their approval prior to the pre-purchase review, the staff member completing the pre-purchase review does not have to duplicate these efforts during their review or documentation of the review.

Pre-purchase reviews may also be entered as a partial purchasing review or a case reading in TxROCS, but this is not required unless the proposed purchase is returned to the caseload for further action for one of the following reasons:

• Proposed purchase is not clearly supported by existing case documentation.
• Proposed purchase is not in the customer's current IPE or most recent IPE amendment.
• Proposed purchase is not clearly connected to and supportive of vocational objective.
• Proposed purchase not allowable under federal regulations or state requirements.

When a proposed purchase Pre-purchase Review is either "complete" (no further action required) or "returned" to the caseload for further action, the caseload carrying team is notified accordingly.

Refer to D-205-4: Exceptions to Purchasing Threshold Requirements for a specific list of goods or services that are exempt from these threshold requirements.

D-205-3: Competitive Bids

Obtaining competitive bids ensures the agency is complying with applicable State purchasing requirements and Federal grant requirements.  We must  also apply best value purchasing principles, as outlined in D-203-2: Best Value Purchasing, to the extent possible.

Services authorizations must not be split to avoid the requirement to obtain bids as this is a violation of State procurement requirements, Federal grant requirements, and purchasing ethics. Therefore, this is subject to corrective action and documentation in the Performance Improvement Plan section of the staff member's next Performance Planning Review.

Competitive Bids Required

Competitive bids are required for the purchase of:

• non-contracted goods and services when:
  • the total cost of purchases from a single service provider or
  • the total cost of a single service authorization (SA) is greater than $10,000;
• tuition and required fees greater than $10,000 per semester for training at an out-of-state or private training institution;
• room and board greater than $10,000 per semester when paid directly to a private or out-of-state training institution; and
• room and board greater than $10,000 per semester when paid to an off-campus housing facility, such as apartment complexes or other rental properties.

When competitive bids are required, these bids may be obtained by field staff and must be documented in a purchasing case note as cost comparisons in a RHW case note.   At a minimum, the bid documentation must include the:

• name, address, and phone number of the providers contacted; and
• details of the responses from providers, such as brand. make, model, description of good or service, and the prices quoted.

If a potential provider is contacted and is not able or willing to provide a bid (cost estimate), this is referred to as a "no bid"; include this in your documentation.

When the service authorization is generated by field staff for a purchase that requires a bid, RHW saves the SA as a draft. The generation of this draft SA alerts procurement staff, who will review the documentation in RHW to ensure compliance with policies and procedures for the specific purchase, including the documentation of the required bids and justification for the use of VR funds. If there are questions or concerns about the documentation, procurement staff will contact the issuer of the SA. Once procurement staff confirm that there is documentation of the required bids, the SA will be released, and field staff may proceed with the purchase. For additional information about draft SA's, refer to the ReHabWorks Users Guide.

Competitive Bids Not Required

Competitive bids are not required for the purchase of:

• goods and services when the total cost of a single SA is less than $10,000;
• goods and services when the total cost of all related purchases from a single service provider is less than $10,000;
• contracted goods and services;
• MAPS purchases;
• tuition and required fees for training at a public training institution in the state of Texas; and
• room and board for training when paid directly to a public training institution in Texas.

If the product or service is not under contract or is not a MAPS purchase, and the cost is less than $10,000, competitive bids are not required; this is referred to as a spot purchase.

Refer to D-205-4: Exceptions to Purchasing Threshold Requirements for a specific list of goods or services that are exempt from these threshold requirements.

D-205-4: Exceptions to Purchasing Threshold Requirements

Purchasing threshold requirements are in addition to any other published policies and procedures for the purchase of specific goods and services. If a good or service is listed below as "exempt" from the purchasing threshold requirements in this section of the VRSM, staff must review other sections of the VRSM to ensure that they have complied with all processes and procedures before generating the service authorization.

The following purchases are exempted/excluded from the purchasing threshold requirements throughout D-205: Purchasing Threshold Requirements:

• contracted hospital services;
• contracted durable medical equipment (DME);
• contracted orientation and mobility or diabetes education services;
• contracted hearing aids and related products;
• interpreter/CART services for students enrolled in training programs for longer than 30 days when paid to paid directly to the training institution or an appropriately contracted service provider;
• medical goods and services, including orthotics and prosthetics and low-vision devices, purchased using MAPS codes;
• tuition, required fees, and room and board for training when paid directly to a public training institution in the state of Texas (excludes room and board paid to other entities, such as apartment complexes and private training institutions);
• contracted vehicle modifications;
• contracted services, as established and described in the VR Standards for Providers manual; and
• all other contracted goods and services to include purchases made using contracts established by the State Comptroller for Public Accounts and the Department of Information Resources (DIR).

Multicustomer SAs

The purchasing threshold requirements in D-205: Purchasing Threshold Requirements do not apply to the total cost of a multicustomer service authorizations. However, threshold requirements do apply to multicustomer service authorizations when a per customer cost reaches one of the threshold amounts. When a per customer cost reaches one of the threshold amounts, including the $5,000 threshold for pre-purchase reviews, the purchase requires the same approvals and reviews as a single non-multicustomer SA would require.

For additional information about multicustomer SAs, refer to D-213-5: Multicustomer Purchases.

Goods and services must be authorized with an SA before obtaining a good or service. The issue date of the SA must be dated on or before the start date.

D-207-1: Free-on-Board (FOB) Destination

When issuing an SA for goods that will be shipped to the VR office or directly to the customer, include "FOB destination" on the SA as a condition of the purchase.

If the provider does not ship FOB destination, the VR counselor locates another vendor, if possible.

FOB means that VR does not own the goods until they arrive and are accepted at the destination identified on the SA. The risk of loss to goods does not pass to VR until the goods are delivered and the shipment is accepted. When goods are damaged in transit or are not accepted or received, the provider ships new or replacement goods without additional expense to VR.

D-207-2: Verifying Receipt of Goods and Services

An essential part of the purchasing process is to confirm that:

• the goods were delivered in good condition and met the specifications; or
• the services were completed according to the specifications.

D-207-3: Accepting a Delivery of Goods

When customer purchases are delivered to a VR office, the deliveries are processed in the same way that other administrative deliveries are processed.

Before accepting the delivery, VR staff:

1. verify that the shipment is addressed to the appropriate office;
2. inspect the shipping packages for any visible damage; and
3. ensure that the shipment contains the number of packages stated on the shipping documentation; and
4. acknowledge the shipment by signing the shipping document, if the shipment:
   • appears undamaged;
   • matches the quantity on the shipping document; and
   • is correctly addressed to the receiving VR office.

After accepting the delivery, VR staff assesses and documents the shipment's status in an RHW case note.

If the shipment appears damaged but the damage seems minor, VR staff:

• accepts the shipment, noting the number of damaged packages on the shipping document; or
• refuses the shipment, noting that the refusal is due to damages to the shipment.

If the damage is or appears to be severe, VR staff:

• refuses the shipment, noting the refusal and the damages on the shipping document; and
• notifies the vendor and the VR counselor about the damaged shipment.

VR staff does not accept:

• goods that arrive COD (that is, collect or cash on delivery); or
• deliveries made to the wrong office.

If a vendor erroneously ships COD, the VR staff member refuses the shipment.

If goods or services do not meet the appropriate conditions listed above, the VR staff member initiates corrections. When the goods or services meet the conditions, the VR staff member documents the receipt in RHW.

Recording Serial Numbers

When a good that is received at a VR office has a serial number, the serial number must be recorded as part of the documentation when delivery of a good is accepted. Until a field is added to RHW for recording the information as part of the receipt process, the VR staff member enters it in a RHW case note for future reference.

D-207-4: Documenting Receipt of Services

To verify that services were delivered, VR staff:

1. contacts the customer or the customer's representative by email, by phone, or in person; or
2. obtains written documentation that includes the customer's or representative's signature.

Verification by Email, Phone, or In Person

VR staff documents contacts with the customer or the customer's representation in a case note in RHW. VR staff contacts the customer to verify that the service met the specifications and documents the contact in a case note.

If the customer is not available to verify receipt of the service, VR staff must document in case notes, in a timely manner, all attempts to verify receipt of the service.

If 20 days have passed since receipt of the invoice and attempts to contact the customer have been unsuccessful, VR staff:

1. continues to attempt contacting the customer; and
2. records in case notes each attempt.

Verification by Written Documentation

Some goods and services require that the customer verify receipt of the good or service by signing a specific document or form. These requirements are stated in the chapter that corresponds to the service or in the SFP and can also be stated on the required form.

When VR staff obtains written documentation that includes the customer's signature verifying that the service met the specifications, the documentation is filed in the customer's paper case file.

When a customer's signature is required, but the customer cannot be contacted to obtain the signature, VR staff contacts the VR Supervisor for guidance. VR staff must document in case notes, in a timely manner, all attempts to contact the customer to obtain the required signature.

Verification by the Customer's Representative

If someone other than the customer or the customer's representative serves as the contact, see VRSM A-207: Confidentiality and Use of Customer Records and Information.

Payment Action Items

For payment of services related to maintenance or transportation, RHW automatically creates an action item to receive the records once an SA is generated. See the ReHabWorks User's Guide: E-500: Case Authorizing Payment, E-502: Maintenance and Transportation for additional instructions.

Provider Reports

In some cases, VR purchases a service that requires the provider to submit a report, for example, submitting the results of a medical examination in the form of a medical report.

The receive date is the date that the examination (the service) takes place.

The invoice receive date is the date that the invoice was received for the service that was provided.

The report receive date is an additional date in RHW that is entered for all services that require a report. The report receive date is the date that the report is received in the office listed on the SA. VR staff enters the receive date for the report in RHW within seven calendar days of receiving a complete and accurate report.

All of these dates must be entered into RHW before the payment can be authorized.

For a detailed list of services that have report requirements, refer to the ReHabWorks User's Guide, Appendix G: Service Category Descriptions.

D-207-5: Customer Warrants Mailed to the VR Office

VR Manager approval is required before VR staff arranges that a customer's warrant is mailed to the VR office.

When a transportation warrant is received in the VR office, the VR counselor or RA:

1. documents the receipt of the warrant in RHW. The case note must contain:
   • the date that the warrant was received, and
   • the warrant number and amount.
2. contacts the customer and documents the contact in RHW; and
3. documents in RHW once the customer obtains the warrant. The case note must contain:
   • the date that the warrant was received by the customer, and
   • the warrant number and amount.

Until the customer receives the warrant, it must be stored under lock and key.

Goods and services can be purchased for customers from a variety of community rehabilitation programs and vendors, including contracted providers, noncontracted providers, and medical service providers.

Each type of purchase has steps that must be completed to ensure compliance with state comptroller's purchasing requirements.

D-209-1: Noncompetitive Purchases

Noncompetitive purchases are those purchases of goods and/or services from a single vendor that cost $10,000 or less. These purchases do not require competitive bids, but they must conform to the purchasing guidelines and principles stated in this chapter and in the applicable chapters of the VRSM and VR Standards for Providers related to the good or service being purchased.

Purchases of goods and/or services from a single vendor that cost more than $10,000 must be competitively bid or approved as a proprietary or sole source purchase. For more information, refer to D-205-3: Competitive Bids and D-209-2: Proprietary and Sole Source Purchases.

Exception: Medical goods and services purchased using MAPS codes, contracted goods and services, and in-state public college/university tuition and fees do not require a competitive bid.

For information about obtaining required bids (for example, RHW bid requests), VR staff contacts the TWC Purchasing Team at consumer.procurement@twc.texas.gov.

D-209-2: Proprietary and Sole Source Purchases

A proprietary or sole source purchase is made when only one brand name (manufacturer) or only one provider can meet TWC's specifications for the product or service because of distinctive features or characteristics that are not provided by competing companies, similar products, or comparable services.

When the specifications limit consideration to one product or supplier, the paper case file must contain a complete and approved VR1322, Proprietary Purchase Justification.

Justification for a proprietary or sole source purchase is required, if the above condition and one or more of the following apply:

• The planned purchase exceeds $10,000
• The planned purchase does not involve MAPS
• The planned purchase is not for tuition and fees
• No contract is required

A proprietary purchase or sole source transaction must not exceed $25,000. Exceptions are not allowed to this policy.

An example of a proprietary purchase is a Humanware BrailleNote Notetaker, a unique device that is available from only one provider.

D-209-3: Contracted Goods and Services

When purchasing contracted goods and services, the VR counselor refers to the:

• VR Standards for Providers; and
• TWC Procurement and Contract Handbook.

Contract Administration staff members solicit and manage contracts for VR goods and services. Some goods and services must be purchased under contract. Before purchasing a good or service, staff members use RHW to find out whether a contract is required. When the service authorization (SA) is generated, RHW assigns the contract number based on the vendor and the type of purchase. Refer to RUG E-200: Case Service Records for more information about creating a service record.

Customer goods and services that are purchased under contract include, but are not limited to, the following:

• Employment assessments
• Orientation and Mobility services
• Hearing aids and related accessories
• Diabetes Self-Management Education services
• Durable medical equipment
• Assistive technology
• Supportive Residential Services for Persons in Recovery
• Work Readiness services
• Work Experience
• Pre-Employment Transition services
• Project SEARCH and similar programs
• Basic Employment services
• Supported Employment services
• Self-Employment services (including supported self-employment)
• Employment Supports for Brain Injury services
• Vehicle modifications
• Intensive Work Preparation and Life Skills Training

When purchasing an outcome-based contracted training service, such as Vocational Adjustment Training, the service is purchased no more than one time. When there is a significant change in circumstances that may justify an additional purchase of the same service, approval and completion of VR3472, Contracted Service Modification Request, is required. Refer to D-210-4: Completing VR3472, Contracted Service Modification Request for more information.

Ensuring a Valid Contract

Before issuing an SA, VR must:

1. note the contract number on the documentation for a good or service purchased under contract; and
2. ensure that the contract number is current on the service record.

When creating a service record in RHW to purchase goods or services that require a contract, VR staff ensures that the contract for the selected good or service is valid for the entire planned period of service.

To confirm that a contract is valid for the entire planned period of service, VR staff:

1. Reviews the provider's contract information in RHW on the Service Record page by selecting:
   • the Vendor Detail button;
   • the vendor's name; and
   • the contract number; and
2. Reads the contract details carefully to ensure that:
   • the contracted good or service is included in the contract; and
   • the dates of service are within the contract's start and end dates.

If the contract is not valid when the good or service is purchased or delivered, VR staff does not use that good or service but instead:

1. continues to search in RHW for a valid good or service; and
2. consults with the VR Manager if you are unable to locate a valid good or service.
3. enters in the comments section of the SA all special instructions or requirements for the specific good or service being purchased.

D-209-4: Billing for Medical and Psychological Services

Payment for medical and psychological services must be authorized by VR and must support VR services and goals.

Medical and psychological services purchased for customers must use MAPS coding and pricing in RHW. No other type of SA may be issued.

Medical and psychological services, including medical goods and supplies, are purchased using MAPS coding and pricing. MAPS codes establish the maximum payment that can be authorized for these services. VR staff members work closely with the provider to ensure that payment corresponds to the correct MAPS codes. Treatment decisions and accurate identification of the applicable MAPS code are the responsibility of the customer's health care provider and designated program staff members or consultants.

Before generating an SA in RHW, VR staff must consult the MAPS Guidelines for instructions about MAPS-related purchases.

The Medical Services Required Practices Handbook (PDF) provides additional guidance to the medical services coordinator (MSC), VR counselors, and rehabilitation assistants who coordinate medical services for VR customers.

For additional information about purchasing medical services, refer to C-700: Medical Services.

Part of the process to set up and pay providers requires VR staff to ensure that the vendor, customer, or individual:

• has the necessary qualifications, credentials, and/or licenses;
• is established in ReHabWorks (RHW) as a provider; and
• is linked to the appropriate specifications.

after the steps above have been taken, VR staff should:

• commit to a specific service from a vendor, customer, or individual;
• generate a service record; and
• issue a service authorization.

If the service provider, customer, or individual is not already established as a provider, VR staff (generally the unit purchasing specialist) sends the TWC Substitute W9 and Direct Deposit Form (VR1020) with instructions to the potential vendor for its completion.

VR staff explains that the purpose of the VR1020 is to gather information required to establish the provider as a vendor with the State of Texas, enabling VR staff to:

• establish the provider in ReHabWorks;
• issue service authorizations and payments; and
• complete IRS Form 1099, which documents the amount paid to the vendor for tax purposes.

The prospective vendor returns the completed form to the providing VR staff member.

If it is necessary to enter data about customers, parents, and/or guardians into RHW to enable payment of maintenance, periodic transportation, customer airfare, and the like:

• VR staff provides the customer (parent or guardian, if applicable) with the Consumer or Parent/Guardian Information and Direct Deposit Form (VR1021) with the instructions; and
• the customer (or parent or guardian) returns the completed form to the VR staff member.

The Unit Purchasing Specialist (UPS) or VR staff member reviews the forms for completeness and accuracy of data to the extent possible. If the form is incomplete or inaccurate, the UPS or VR staff member returns it to the prospective vendor or customer (or parent or guardian) and requests that the form be corrected and resubmitted.

As applicable for purchased goods and services, the UPS works with the requesting staff member to verify that the provider has the necessary qualifications, credentials, and/or licenses before requesting the vendor be set up and linked. Refer to the applicable policy for the good or service for qualification requirements, such as C-400: Training Services for licensure and accreditation requirements for schools or C-700: Medical Services and Equipment for credential requirements for therapeutic providers.

The UPS or VR staff member emails the appropriately completed form to VR RHW Provider Services and includes the RHW specification-level codes and descriptions to which the vendor or customer should be linked.

VR RHW Provider Services or other state office program specialists will ensure that the provider has the required qualifications, credentials, and/or licenses for the service and RHW specification-level code requested. If additional information is needed, VR RHW Provider Services will work with the UPS or VR staff member to obtain the required information.

VR RHW Provider Services staff checks WRAPS, Texas Comptroller of Public Accounts (for taxpayer identification numbers (TINS)), and RHW according to the information from the VR1020 and VR1021.

If the information is not listed in any of the three databases or shows discrepancies in WRAPS, TINS, or RHW, an email copying the requesting UPS or VR staff member is sent to VndrSetupMaint_W9 requesting the processing of the attached VR1020 or VR1021. TWC Vendor Setup then processes VR1020 or VR1021 by entering required information into the databases to establish the vendor and set up direct deposit, as appropriate.

Upon completion of the requested setup:

• Vendor Setup Management emails VR RHW Provider Services to inform them that the vendor setup is complete; and
• the vendor information is downloaded overnight into RHW from WRAPS.

The VR RHW Provider Services unit verifies all information entered from the VR1020 or VR1021, creates the physical location, and establishes the requested goods and services link in RHW.

VR RHW Provider Services emails to the UPS or VR staff requester the newly established full VID number with notification that the requested vendor set-up is complete.

VR1020 and VR1021 include additional instructions for completing and submitting the forms to establish the vendors in RHW.

Note: State law prohibits the Texas Comptroller of Public Accounts from paying funds directly to anyone who owes the state because of certain taxes, student loans or child support.

Refer to D-206-2: Payee Restrictions for additional policies and procedures regarding restrictions related to the provider's association with the VR customer and how this may impact the purchase of goods and services.

Note: VR staff sends all vendor-related forms and inquires to the VR RHW Provider Services mailbox. VR RHW Provider Services acts as a clearinghouse for RHW vendor-related information and requests and will route all forms or inquiries to the appropriate office.

The types of payments and purchases that can be processed in RHW include:

• periodic payments;
• advance payments; and
• restricted donations.

D-213-1: Periodic Payments

Periodic payments are used when a service is provided and paid over a defined but recurring period (for example, training programs that bill monthly, or reader services that bill at regular intervals).

The receive date for periodic payments is the last day of the billing period. When the periodic payment is for one month, for example, the receive date for each payment is the last day of the month.

For information about how to enter a periodic payment in RHW, see the ReHabWorks User's Guide: E-500: Case Authorizing Payment.

D-213-2: Advance Payments

Advance payment or prepayment occurs when payment for a customer service is issued before the service is delivered. Payment usually is not made until a service is received.

Customer services for which advance payment may be authorized are described in the Advance Payment Table below.

When advance payment is authorized, payment authorization must be delegated in accordance with RHW procedures.

Advance Payment Table

The table below lists the only circumstances under which an advance payment may be issued. Advance payments may be received and authorized anytime from the "pay as early as" date to the actual completion date of the service. The date entered in the receipt acknowledgment field in RHW is the receive date. Use the billing statement as the invoice for receiving and paying. If the vendor's billing statement for advance payment situations lacks the required invoice data but all other information is accurate and complete, the VR staff member attaches the RHW system-generated billing cover sheet for the SA to the billing statement. The combination of the two documents serves as the invoice for the associated SA.

Advanced Pay Situations	Pay as early as
Maintenance	Seven days before the start date
Transportation	Seven days before the start date
Child Care	Seven days before the start date
Academic and vocational training and training-related services (when provided by an accredited college or university over a semester or quarter)	Time of enrollment
Vocational or technical training (when provided by an accredited training institution)	Time of enrollment
*Room and board to support planned training activities	14 days before the start date
State board licenses the registration for an exam	14 days before the start date
Medical Records – only in circumstances in which advanced payment is required by the provider	Same day the SA is issued

*For example, if a customer's room and board had a start date of 8/16/2020 and an end date of 12/17/2020, the payment could be received any day between 8/2/2020 and 12/17/2020. If the bill or receipt is entered on 8/7/2020, the receive date entered in RHW is 8/7/2020.

D-213-3: Restricted Donations Payments

A restricted donation is a cash donation made to VR to provide services to VR customers for a specific purpose, program, VR office, or caseload. When a restricted donation is received, the receiving office immediately notifies the office of the VR Division Director.

D-213-4: Payment Discounts

For information on how to apply payment discounts, see the ReHabWorks User's Guide: E-400: Case Acknowledgement of Receipt, E-401-1: Payment Discounts.

D-213-5: Multicustomer Purchases

A multicustomer purchase is made when services are purchased from a single provider for multiple customers. Customers may be on or from the same or different caseloads.

A multicustomer service record (SR) completed in RHW serves the same function as an individual SR and is used to create a multicustomer service authorization (MCSA).

Information related to multiple customers must never be filed in an individual customer's file.  Invoices that include the names of multiple customers must be kept in a separate file; therefore, separate invoices are not required for each customer. Individual reports may be maintained in the individual case file since no identifying information for other customers is documented within the report.

For additional information on creating multicustomer SRs and MSCAs, refer to the ReHabWorks User's Guide, Chapter 20: Multicustomer Purchases, 20.1 Multicustomer Service Record.

D-213-6: Food Purchased for Customer Training

The purchase of food for customer training must be necessary and reasonable.

Prior to purchasing food, VR staff must take the following into account:

• Food may not be purchased to feed customers unless the training is scheduled to exceed five hours, not including the meal hour. Customer training should not be planned over a meal period with the intent of purchasing food. Meals should be purchased only when doing so will allow customers to continue their training activities during the meal or will support completion of the training in less time.
• Food purchases must be only for customers, must not be an excessive quantity or variety, and must be a reasonable cost. The cost per meal should be as economical as possible and must not exceed $15 per customer. When a training spans a full day or multiple days, the daily cost per customer for food must not exceed $51. Any exceptions to these limits must be approved in advance by the VR director.
• Food may not be purchased to feed VR staff, individuals from partner organizations, or family members. The only exception is when a family member’s participation meets the requirements established in VRSM C-1307-2: Family Participation in Training Seminars and GSTs, and when the purchase of food for the family member is approved in advance by the VR director.
• Per Federal regulations, food is only an allowable Pre-ETS expenditure when the student is VR eligible with an IPE in place and it directly supports participation in a Pre-ETS activity. Food is not an allowable expense for potentially eligible customers.
• Food that is provided in conjunction with other customer activities, such as seminars and workshops and activities in the community, is not categorized as bulk food orders and should be purchased through RHW.

D-213-7: Used Goods

The following policy does not apply to the purchase of medical or assistive devices, such as hearing aids, orthotics, prosthetics, or surgical implantable devices.

Used goods, supplies, or equipment can be purchased with VR funds when new equipment is unavailable or when used equipment meets the customer's needs and provides significant savings (such as purchasing used textbooks).

Include the justification for the purchase of used equipment in the service justification case note.

When buying used goods, the VR staff member processes the order according to the applicable procurement method, which is based on the estimated cost of the equipment.

Documentation of the purchase must include a description of the equipment's condition and value (usually found on the cost estimate or the provider's invoice, but may be added to the SA).

D-213-8: Scheduling of Payments Greater than $5,000

In accordance with the obligations and responsibilities established by Texas Government Code §2155.382(d), the Texas Comptroller requires the scheduling, rather than immediate processing, of individual payments greater than $5,000. As a result, single payments that are greater than $5,000 will be scheduled to process on "the last day on which payment can be made without accruing interest under the prompt payment law", or just less than 30 days. For reference and additional context, see VRSM D-507-2: Prompt Payment Act.

When staff are notified by State Office that ReHabWorks is not available, VR management or its designee will provide staff members with direction regarding the continuation of purchasing processes and procedures.

Texas state agencies provide a variety of goods and services for each other. For example, the Texas Department of Aging and Disability Services (DADS) provides medical records, and the Texas Cosmetology Commission provides state cosmetology licenses.

For some agencies, the state comptroller transfers funds from one agency to another through interagency transfer vouchers (ITV) instead of issuing a warrant to make the payment.

D-217-1: Receiving and Paying Interagency Transfer Vouchers

When receiving and paying ITVs, a VR staff member in the field office verifies the ITV's accuracy.

Note: If the invoice or ITV does not have a recurring transaction index (RTI) number, the VR staff member:

1. calls the performing agency to get the RTI number; and
2. writes it on the invoice or ITV.

The staff member then:

1. verifies that the goods or services have been received;
2. acknowledges receipt of the invoice, goods, and/or services, and documents in RHW (if applicable):
   • the invoice number in the Invoice Number field in the Receive Items List window, if the performing agency provided an invoice number (if an invoice number is not provided, the customer's Social Security number); and
   • the six-digit RTI number; and
3. writes the voucher document number assigned in RHW on the invoice or ITV (the number begins with a "T").

Note: Request payment using the SA Payment Authorization window. If the invoice includes fees for late payment, do not pay them.

The state comptroller maintains an Interagency Transactions Contact List, which is a list of agency contacts for RTI numbers.

Listed below are the required qualifications for physicians, specialists, and other health care professionals.

The TWC-VR state program specialist for physical restoration:

• verifies in RHW the required qualifications of health care professionals; and
• provides information about certification or licensure of other health care professionals.

Note: When an intern working under the supervision of a licensed provider provides counseling services, the services are purchased at the rate paid for the supervising licensed provider.

Professional	Job Function	Required Qualifications
Advanced practice nurse	Provides medical evaluation and/or treatment	Licensed by the Texas Board of Nursing
Audiologist	An audiologist: provides audiological examinations; may dispense hearing aids; and may provide basic audiometric assessments.	Licensed by the State Board of Examiners for Speech-Language Pathology and Audiology To dispense hearing aids, the audiologist also must be licensed by the State Committee of Examiners in the Fitting and Dispensing of Hearing Instruments.
Certified registered nurse anesthetist (CRNA)	Administers anesthesia	Certified by the American Association of Nurse Anesthetists
Chiropractor	Provides manipulative treatment of the spine and functional capacity assessments For restrictions, see C-703-6: Chiropractic Treatment.	Licensed by the Texas Board of Chiropractic Examiners
Cognitive rehabilitation therapist	Provides cognitive rehabilitation therapy, which focuses on the development of cognitive skills (the ability to perceive, recognize, conceive, judge, imagine, and reason) that were lost or altered because of neurological damage The aim of treatment is to enhance functional competence in real-world situations. The process includes: direct retraining; use of compensatory strategies; and/or use of cognitive tools.	One of the following: For a psychologist, a license from the State Board of Examiners of Psychologists For a psychiatrist, a license from the State Board of Medical Examiners For an occupational therapist, a license from the Executive Council of Physical Therapy and Occupational Therapy Examiners For a speech and language pathologist, certification from the State Committee of Examiners for Speech and Language Pathologists and Audiologists
Dentist	Provides dental evaluations and/or treatment	Licensed by Texas State Board of Dental Examiners to practice in the state where services are rendered
Hearing aid specialist	Dispenses hearing aids May provide basic audiometric assessments (MAPS 92551 - 92559) May provide hearing aid evaluations	Licensed by the Texas Board of Examiners in the Fitting and Dispensing of Hearing Aids
Licensed marriage and family therapist (LMFT)	Provides goal-oriented or problem-centered counseling services, as recommended or prescribed by a psychiatrist or psychologist	Licensed by the Texas State Board of Examiners of Marriage and Family Therapists
Licensed professional counselor	Provides goal-oriented or problem-centered counseling services as recommended or prescribed by a psychiatrist or psychologist	Licensed by the Texas State Board of Examiners of Professional Counselors
Licensed surgical assistant (LSA)	Provides assistant surgeon services	Licensed by the Texas Medical Board
Occupational therapist	Provides: occupational therapy services recommended or prescribed by a physician; home modifications assessment; and/or job analysis and job-site modification assessments.	Licensed by the Executive Council of Physical Therapy and Occupational Therapy Examiners to practice in the state where services are rendered
Optometrist	Provides vision examinations	Licensed by the Texas Optometry Board
Ophthalmologist	Specializes in diagnosis, treatment, and surgery for diseases of the eye	M.D. (doctor of medicine) licensed by the state of Texas State Board of Medical Examiners to practice in the state where services are rendered
Pedorthist	Fabricates and supplies below-the-ankle orthotics	Certified by the Board for the Certification in Pedorthics (C.Ped: certified pedorthists)
Physical therapist	Provides: physical therapy services recommended or prescribed by a physician; home modifications assessment; and/or job analysis and job-site modification assessments.	Licensed by the Board of Physical Therapy and Occupational Therapy Examiners to practice in the state where services are rendered
Physician	Provides medical examinations and/or treatment Exception: A podiatrist licensed in the state where services are rendered may provide medical or surgical services limited to foot conditions.	M.D. (doctor of medicine) or D.O. (doctor of osteopathy) licensed by the Texas State Board of Medical Examiners to practice in the state where services are rendered
Physician assistant	Provides medical examinations, medication management, and/or treatment	Licensed by the Texas Physician Assistant Board
Podiatrist	Provides medical examinations and treatment for foot conditions	Licensed by the Podiatric Medical Examiners Board DPM (doctor of podiatric medicine)
Prosthetist and orthoptist	Fabricates and supplies prostheses and orthotics	Licensed by the State Board of Orthotics and Prosthetics
Psychiatric-mental health advanced practice nurse	Provides evaluation, goal-oriented or problem-centered counseling services, and/or medication management	Licensed by the Texas Board of Nursing
Psychologist	Provides or supervises the provision of psychological services When an individual under the supervision of the licensed psychologist provides services, the licensed psychologist must sign all reports	Licensed by the Texas State Board of Examiners of Psychologists or licensed to practice in the state where service is rendered (unless exempt) Community-based behavioral health and developmental disability services centers and some state agencies are exempt from the licensing act
Registered nurse first assistant (RNFA)	Provides assistant surgeon services	Licensed by the Texas Board of Nursing
Social Worker	Provides goal-oriented or problem-centered counseling services for customers as recommended or prescribed by a psychiatrist and/or psychologist	Licensed Clinical Social Worker (LCSW) licensed by the Texas State Board of Social Work Examiners Community-based behavioral health and developmental disability services centers and some state agencies are exempt from the licensing act
Specialist physician	Performs examinations, treatment, and/or surgery	Physician certified by an American Medical Specialty Board, or the American Osteopathy Specialty Board in the needed specialty When a board-certified physician is not available, refer the customer to the Texas Medical Board Look Up a License page to gather information about the education and experience of a physician without board certification.
Speech-language pathologist	Provides, with concurrence of a physician, speech and hearing therapy after surgery or trauma affecting speech	Certified as a speech-language pathologist by the State Board of Examiners for Speech-Language Pathology and Audiology
Speech trainer	Provides speech training in both expressive (speech language production) and receptive (lip and speech reading) language May also evaluate and provide training in the use of speech augmentation devices	Certified as a speech-language pathologist by the State Board of Examiners for Speech-Language Pathology and Audiology

When considering telehealth options for customers, VR counselors carefully consider what types of treatments that use telehealth are the most effective and decide on a case-by-case basis whether to proceed with telehealth.

The U.S. Department of Health and Human Services (HHS) issued guidance on using Health Insurance Portability and Accountability Act (HIPAA)-compliant platforms.

HHS lists the following as vendors that represent that they provide HIPAA-compliant video communication products:

• Skype for Business/Microsoft Teams
• Updox
• VSee
• Zoom for Healthcare
• Doxy.me
• Google Meet on G Suite
• Cisco Webex Meetings/Webex Teams
• Amazon Chime
• GoToMeeting

When providing telehealth options, it is recommended that providers use an application listed by HHS or another HIPAA-compliant application.

D-221-1: Creating a Service Authorization for Telehealth Services

Telehealth options are available for the following services:

• Autism Spectrum Disorder Supports, refer to VRSM C-802: Autism Spectrum Disorder Supports;
• Applied Behavior Analysis, refer to VRSM C-803: Applied Behavior Analysis;
• Psychological Services, refer to VRSM C-804: Psychological Services; and
• Medical Services, refer to VRSM C-701: Professional Medical Services.

A service record must be created with the following specifications for telehealth services:

Service Records for Medical and Psychological Services

• Level 1: Medical and Psychological Evaluations and Services (MAPS)
• Level 2: Evaluation & Management (General Evals, Office & Home Visits, Supplies, Injections)
• Level 3: Office/Outpatient/Hospital Consultations

Choose the appropriate specifications for Level 4 based on the service to be provided.

Note: There are no changes to rates for the following telehealth services:

• Licensed Professional Counselor (LPC) counseling,
• Social Worker counseling,
• Applied Behavior Analysis (ABA) services, and
• Autism Spectrum Disorder (ASD) supports.

Service Records for ABA Services by BCBA-D

• Level 1: Medical and Psychological Evaluations and Services
• Level 2: Applied Behavior Analysis and Behavior Intervention Services by BCBA-D
• Level 3: Applied Behavior Analysis and Behavior Intervention Services by BCBA-D

Choose the appropriate specifications for Level 4 based on the service to be provided.

Service Records for ABA services by BCBA

• Level 1: Medical and Psychological Evaluations and Services
• Level 2: Applied Behavior Analysis and Behavior Intervention Services by BCBA
• Level 3: Applied Behavior Analysis and Behavior Intervention Services by BCBA-D

Choose the appropriate specifications for Level 4 based on the service to be provided.

Service Records for ABA services by BcaBA, RBT, or Graduate Student under supervision of BCBA-D or BCBA

• Level 1: Medical and Psychological Evaluations and Services
• Level 2: Applied Behavior Analysis and Behavior Intervention Services by BCaBA, RBT, or Graduate Student Under the Supervision of a BCBA-D or BCBA
• Level 3: Applied Behavior Analysis and Behavior Intervention Services by BCaBA, RBT, or Graduate Student Under the Supervision of a BCBA-D or BCBA

Choose the appropriate specifications for Level 4 based on the service to be provided.

Service Records for Autism Spectrum Disorder (ASD) supports

• Level 1: Evaluation Services (non-MAPS), Other Training & Related Services
• Level 2: Autism Spectrum Disorder (ASD) Supports - reference VRSM C-800: Neurodevelopmental and Psychological Services
• Level 3: Autism Spectrum Disorder (ASD) Supports

Choose the appropriate specifications for Level 4 based on the service to be provided.

Service Records for Licensed Professional Counselor (LPC) counseling

• Level 1: Medical and Psychological Evaluations and Services (MAPS)
• Level 2: Licensed Professional Counselor (LPC) counseling, per hour

Choose the appropriate specifications for Level 3 and 4 based on the service to be provided.

Service Records for Social Worker counseling

• Level 1: Medical and Psychological Evaluations and Services (MAPS)
• Level 2: Social Worker counseling services

Choose the appropriate specifications for Level 3 and 4 based on the service to be provided.

Note: When a customer receives telehealth services during a pandemic, VR staff should refer to the VRD state office guidance and Texas Department of Insurance - Telemedicine emergency rule for information on telehealth billing and payment guidelines.